Osteoarthritis is an extremely common disease among middle-aged and elderly patients, and its incidence increases greatly with age, with a prevalence of up to 80% in the >55 years age group, and about 1/8 of those with symptoms and activity impairment. Artificial joint replacement is an effective means of treating end-stage osteoarthritis. Currently, artificial joints, especially artificial hip and knee replacements, have made great breakthroughs in prosthesis design, material manufacturing, and surgical techniques and perioperative management, and have achieved good long-term results.
I. Basic concepts.
1. What is an artificial joint? The artificial joint is an artificial organ designed to save the joint that has lost its function, and the artificial joint has the best curative effect among the artificial organs. Generally speaking, the service life of artificial joints can be more than 20 years.
2.What patients are suitable for artificial joint replacement surgery? At present, it is considered that, except for acute infectious diseases, active tuberculosis and hematological diseases, joint pain and severe dysfunction caused by many diseases can be replaced by artificial joint surgery (the patient’s age is no longer the most important reference factor), mainly including
(1) Joint deformity or joint destruction due to osteoarthritis.
(2) Ankylosing crepitus; loss of joint function due to rheumatoid arthritis.
(3) Severe localized comminuted fractures of the joint or traumatic osteoarthritis.
(4) Loss of function of the joint due to infection, including specific infections.
(5) Advanced aseptic necrosis of the femoral head.
(6) Non-healing femoral neck fractures or delayed healing of femoral neck fractures in the elderly.
(7) congenital dislocation of the hip joint resulting in joint pain
(8) Bone tumors in and around the joint site.
Why do we need artificial joint replacement?
When there are structural changes in the joint due to various reasons, it is not advisable to use medication alone, because medication can only partially relieve the pain. Artificial joint replacement can achieve the following purposes.
1. Pain relief: It can relieve pain caused by various reasons; for example, pain caused by rheumatoid arthritis, joint destruction, etc.
2. Stabilize joints: stabilize joint instability caused by various reasons; for example, old joint dislocation, severe knee instability combined with osteoarthritis.
3. Correction of deformity: to correct the deformity of the joint at the same time as the artificial joint surgery, so that the original deformity can be corrected and improved.
4.Improve the function of the joint: to restore the normal function of the joint to the original stiff and limited activities.
3. How to choose a good artificial joint?
When a patient decides to use artificial joint replacement treatment, the question is often raised: what kind of artificial joint is the best artificial joint? It should be said that different patients should choose different artificial joints. Artificial joint prosthesis has very strict requirements on its design, surface treatment, material selection, manufacturing process and packaging; it also needs sufficient clinical practice to prove the effectiveness of a certain artificial joint. At present, artificial hip and knee joints have become very mature artificial joints, both in terms of the prosthesis itself and in terms of surgical techniques. In developed countries, artificial joints have been widely used in clinical practice and have achieved good clinical results. Choosing an artificial joint prosthesis is very different from choosing other commodities, because once the artificial joint prosthesis is placed in the body is not easy to “replace”, even if the “replacement” its cost is also quite large, can not be measured only with money. So how to choose a good artificial joint should be under the guidance of experts to make a careful choice.
Fourth, the duration of use of artificial joints and the effectiveness of treatment
The greatest benefit of artificial joint surgery is that it can eliminate joint pain after surgery, greatly improve the function of the joint, and improve the patient’s quality of life so that he can work and live well during his lifetime. Nowadays, more and more patients are willing to accept the suggestion of artificial joint surgery. In general, the service life of an artificial joint is determined by wear and tear, provided that no complications such as infection occur. The strength and wear resistance of artificial joint materials are tested hundreds of times through wear and tear, and high-quality imported artificial joints can generally be used by patients for more than 20 years. The current artificial joints used in clinical practice have improved a lot in terms of manufacturing process and material processing compared to 20 years ago, and it is believed that more than 95% of the artificial joints can continue to be used after 20 years of placement. Of course, the service life of artificial joints is also related to many factors, such as the amount of movement of the patient, the choice of artificial prosthesis, the surgeon’s surgical technique and their own conditions. The orthopaedic community is currently working with engineers and material scientists, among others, to improve artificial joint materials, processes and surgical techniques. The future is bright for patients who choose joint replacement to improve their quality of life and want to be healthy and pain-free in their activities.
V. Post-operative examination
Three months after discharge from the hospital, a review is required to take X-rays to understand whether the position and stability of the joint prosthesis is good. Six months after the operation, another review is required, and then annual radiographs are required. If there is any discomfort, such as redness, swelling, pain or difficulty in moving the joint, or if the hip joint is injured due to an accident, go to the hospital for examination in time.